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‹ Sun · 24 May 2026
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Association between serum cotinine levels and cognitive function in Americans aged 60 and older: A cross-sectional study

Tobacco exposure shows a measurable link to cognitive decline in older adults, identifying a modifiable lifestyle risk factor for brain health in aging.

Using NHANES data (n=2781 adults ≥60), this cross-sectional study found a significant inverse L-shaped association between serum cotinine levels and cognitive function, with harm below an inflection threshold and plateau above it, highlighting tobacco exposure as a modifiable risk factor for cognitive decline in aging populations. The finding supports cotinine as a useful biomarker for monitoring tobacco-related cognitive risk.

What the study was

Study design
Cross-sectional study
Population
US adults aged ≥60 years (NHANES 2011-2014); n=2781
Sample size
2781
Category
Public Health
Maturity
Exploratory
Journal
Medicine (Baltimore)

Why it surfaced

NHANES-based cross-sectional study; decent n=2781; L-shaped relationship with cotinine and cognition is methodologically novel but cross-sectional design limits causal inference. Scored 5.

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